Abstract

Background:

Nighttime noise carries a significant disease burden. The World Health Organization (WHO) recently published guidelines for the regulation of environmental noise based on a review of evidence published up to the year 2015 on the effects of environmental noise on sleep.

Objectives:

This systematic review and meta-analysis will update the WHO evidence review on the effects of environmental noise on sleep disturbance to include more recent studies.

Methods:

Investigations of self-reported sleep among residents exposed to environmental traffic noise at home were identified using Scopus, PubMed, Embase, and PsycINFO. Awakenings, falling asleep, and sleep disturbance were the three outcomes included. Extracted data were used to derive exposure–response relationships for the probability of being highly sleep disturbed by nighttime noise [average outdoor A-weighted noise level ($L_{\text{night}}$) 2300–0700 hours] for aircraft, road, and rail traffic noise, individually. The overall quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.

Results:

Eleven studies ($n=\mathrm{109,070}$ responses) were included in addition to 25 studies ($n=\mathrm{64,090}$ responses) from the original WHO analysis. When sleep disturbance questions specifically mentioned noise as the source of disturbance, there was moderate quality of evidence for the probability of being highly sleep disturbed per 10-dB increase in $L_{\text{night}}$ for aircraft [$\text{odds ratio\hspace{0.17em}}\left(\text{OR}\right)=2.18$; 95% confidence interval (CI): 2.01, 2.36], road ($\text{OR}=2.52$; 95% CI: 2.28, 2.79), and railway ($\text{OR}=2.97$; 95% CI: 2.57, 3.43) noise. When noise was not mentioned, there was low to very low quality of evidence for being sleep disturbed per 10-dB increase in $L_{\text{night}}$ for aircraft ($\text{OR}=1.52$; 95% CI: 1.20, 1.93), road ($\text{OR}=1.14$; 95% CI: 1.08, 1.21), and railway ($\text{OR}=1.17$; 95% CI: 0.91, 1.49) noise. Compared with the original WHO review, the exposure–response relationships closely agreed at low (40 dB $L_{\text{night}}$) levels for all traffic types but indicated greater disturbance by aircraft traffic at high noise levels. Sleep disturbance was not significantly different between European and non-European studies.

Discussion:

Available evidence suggests that transportation noise is negatively associated with self-reported sleep. Sleep disturbance in this updated meta-analysis was comparable to the original WHO review at low nighttime noise levels. These low levels correspond to the recent WHO noise limit recommendations for nighttime noise, and so these findings do not suggest these WHO recommendations need revisiting. Deviations from the WHO review in this updated analysis suggest that populations exposed to high levels of aircraft noise may be at greater risk of sleep disturbance than determined previously. https://doi.org/10.1289/EHP10197

中文翻译：

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环境噪声和对睡眠的影响：世界卫生组织系统评价和荟萃分析的更新

摘要

背景：

夜间噪音会带来严重的疾病负担。世界卫生组织 (WHO) 最近根据对截至 2015 年发布的关于环境噪声对睡眠影响的证据的审查，发布了环境噪声监管指南。

目标：

这项系统评价和荟萃分析将更新世卫组织关于环境噪声对睡眠障碍影响的证据审查，以纳入更多最近的研究。

方法：

使用 Scopus、PubMed、Embase 和 PsycINFO 对在家中暴露于环境交通噪音的居民进行自我报告的睡眠调查。觉醒、入睡和睡眠障碍是包括的三个结果。提取的数据被用于推导出被夜间噪音干扰的高度睡眠概率的暴露-反应关系[平均室外 A 加权噪音水平 (${\mathrm{大号}}_{\text{夜晚}}$) 2300–0700 小时] 分别用于飞机、公路和铁路交通噪声。使用建议分级、评估、开发和评估 (GRADE) 标准评估证据的整体质量。

结果：

十一研究（$n=\mathrm{109,070}$除了 25 项研究（$n=\mathrm{64,090}$响应）来自最初的 WHO 分析。当睡眠障碍问题特别提到噪音作为干扰源时，有中等质量的证据表明，每增加 10 分贝，睡眠受到高度干扰的概率${\mathrm{大号}}_{\text{夜晚}}$飞机 [$\text{优势比\hspace{0.17em}}\left(\text{或者}\right)=2.18$; 95% 置信区间 (CI): 2.01, 2.36], 道路 ($\text{或者}=2.52$; 95% CI：2.28、2.79）和铁路（$\text{或者}=2.97$; 95% CI：2.57, 3.43) 噪声。当没有提到噪音时，每增加 10 分贝，睡眠受到干扰的证据质量从低到非常低。${\mathrm{大号}}_{\text{夜晚}}$飞机用 ($\text{或者}=1.52$; 95% CI: 1.20, 1.93), 公路 ($\text{或者}=1.14$; 95% CI：1.08, 1.21）和铁路（$\text{或者}=1.17$; 95% CI：0.91, 1.49) 噪声。与最初的 WHO 审查相比，暴露-反应关系在低 (40 dB${\mathrm{大号}}_{\text{夜晚}}$) 所有交通类型的水平，但表明在高噪声水平下飞机交通的干扰更大。欧洲和非欧洲研究之间的睡眠障碍没有显着差异。

讨论：

现有证据表明，交通噪音与自我报告的睡眠呈负相关。这个更新的荟萃分析中的睡眠障碍与低夜间噪音水平下的原始世卫组织审查相当。这些低水平对应于最近世界卫生组织对夜间噪音的噪音限制建议，因此这些发现并不表明世界卫生组织的这些建议需要重新考虑。本次更新分析中与世卫组织审查的偏差表明，暴露于高水平飞机噪音的人群可能比先前确定的面临更大的睡眠障碍风险。https://doi.org/10.1289/EHP10197